Abstract
We used 1997–2004 National Health Interview Survey data to evaluate the prevalence of sensory impairment among US workers 65 years and older. Hearing impairment prevalence was 3 times that of visual impairment (33.4% vs 10.2%), and 38% of older workers reported experiencing either impairment. Farm operators, mechanics, and motor vehicle operators had the highest prevalence of sensory impairment. Workplace screening and accommodations, including sensory protection devices for older workers, are warranted given the greater risk for injuries among the sensory impaired.
Americans are living longer and are delaying retirement. As a result, the number of older US workers is increasing rapidly, with more than 40 million American workers 65 years and older projected to be in the workforce by 2012.1 Older age is associated with a higher prevalence of sensory impairment,2,3 which in turn is associated with an increased risk of occupational injury.4–6 One public health implication of an increasingly older workforce is a continued rise in workplace injuries. An estimated 3.9 million cases of workplace injuries were reported in 2006,7 a disproportionate amount of which were among older employed men.8 Research on the prevalence of sensory impairment by occupational and industrial worker groups is needed to identify older US workers in greatest need of workplace accommodations. We examined the prevalence of vision and hearing impairment among older workers with data from a nationally representative sample of US worker groups.
METHODS
The National Health Interview Study is an annual survey of the US civilian noninstitutionalized population conducted by the National Center for Health Statistics with a continuous, multistage probability cross-sectional design.9,10 A probability sample of households is selected, with 1 randomly selected adult asked to complete a health-oriented interview, which includes questions about visual impairment and hearing impairment. Annual response rates for this interview in the period we analyzed ranged from 80% in 1997 to 72.5% in 2004.3,11,12 Workers were classified into broad occupational and industrial sectors, as well as more-detailed occupational categories, by occupational and industrial coding derived from reported employment in the week prior to the interview.13–15
Nearly 5600 working adults 65 years or older were asked, (1) “Do you have any trouble seeing, even when wearing glasses or contact lenses?”; (2) “Are you blind or unable to see at all?”; and (3) “Which statement best describes your hearing (without a hearing aid): good, a little trouble, a lot of trouble, or deaf?” Participants responding yes to either of the first 2 questions were considered to be visually impaired. Participants reporting any trouble hearing or deafness were classified as hearing impaired.
We used SUDAAN version 8.0.2 (Research Triangle Institute, Research Triangle Park, NC) for all analyses to take into account sample weights and design effects. Sample weights were adjusted to account for the aggregation of data over survey years 1997 to 2004.16
Subgroup sensory impairment prevalence rates were considered significantly higher than the overall sample prevalence rate if the subgroup rate was above the upper bound of the 95% confidence interval for the entire sample. This method was a variation on the method of testing a 1-sample difference in proportions that considered the overall sample as the population proportion.17
RESULTS
More than 49 000 adults 65 years or older with sensory impairment data participated in the National Health Interview Study from 1997 to 2004. Of these, 5590 (11.4%) were employed, representing approximately 3.9 million older US workers. The majority of workers reported their race as White (89.2%), with approximately equal proportions of women and men (Table 1).
TABLE 1.
Demographic Characteristics of the Sample (N = 5590) and All US Workers 65 Years and Older (N = 3 896 639): National Health Interview Survey, 1997–2004
| Demographics | Sample, No. | All Older Workers,a No. | Weighted Prevalence,b % (95% CI) |
| Gender | |||
| Men | 2763 | 2 180 123 | 55.9 (54.4, 57.4) |
| Women | 2827 | 1 716 516 | 44.1 (42.5, 45.5) |
| Age, y | |||
| 65–69 | 2971 | 2 122 772 | 54.5 (53.0, 55.9) |
| 70–75 | 1718 | 1 180 597 | 30.3 (28.9, 31.7) |
| 76–80 | 655 | 436 426 | 11.2 (10.3, 12.1) |
| ≥ 81 | 246 | 156 844 | 4.0 (3.5, 4.6) |
| Race | |||
| White | 4833 | 3 475 224 | 89.2 (88.2, 90.2) |
| Black | 604 | 314 725 | 8.1 (7.2, 8.9) |
| Other | 153 | 106 691 | 2.7 (2.1, 3.3) |
| Ethnicity | |||
| Hispanic | 443 | 207 465 | 5.3 (4.6, 5.9) |
| Non-Hispanic | 5147 | 3 689 174 | 94.7 (94.9, 95.3) |
| Marital status | |||
| Married/living with partner | 2733 | 2 511 369 | 64.6 (63.2, 65.9) |
| Divorced/widowed/separated | 2557 | 1 243 587 | 32.0 (30.7, 33.2) |
| Single | 285 | 134 891 | 3.5 (3.0, 4.0) |
| Economic statusc | |||
| At or below the poverty line | 181 | 101 431 | 2.6 (2.1, 3.1) |
| Above the poverty line | 3710 | 2 559 410 | 65.7 (64.2, 67.2) |
| Education, y | |||
| < 12 | 1144 | 718 539 | 18.6 (17.4, 19.9) |
| 12 | 1803 | 1 284 824 | 33.3 (31.8, 34.8) |
| > 12 | 2597 | 1 855 086 | 48.1 (46.5, 49.7) |
| Health insurance coverage | |||
| No | 78 | 52 298 | 1.3 (0.9, 1.7) |
| Yes | 5506 | 3 840 517 | 98.7 (98.1, 98.9) |
Note. CI = confidence interval.
Population estimates for the total US older workforce were based on the National Health Interview Survey sampling weights.
Column percentages may not sum to 100% because of rounding and missing data.
Approximately 35% of older workers did not report financial data; caution should be taken when interpreting these findings. Status was based on preceding year of data collection for that individual.
Nearly 4 in 10 older workers reported either visual or hearing impairment, with just over 5% reporting both (Table 2). The overall prevalence rate of hearing impairment was approximately 3 times that of visual impairment (33.3% vs 10.2%, respectively). Farm operators and managers reported the highest impairment levels. Relative to all workers, farm operators and managers reported the highest visual impairment (15.4%), hearing impairment (53.9%), hearing and visual impairment (12.1%), and hearing or visual impairment (57.3%). National Occupational Research Agenda industrial sectors with significantly higher prevalence of sensory impairment relative to all workers included agriculture, forestry–fishing (visual impairment, 14.0%; hearing impairment, 45.0%; hearing and visual impairment, 9.8%; hearing or visual impairment, 43.7%), and construction (visual impairment, 12.8%; hearing impairment, 36.4%; visual or hearing impairment, 40.6%).
TABLE 2.
Prevalence of Visual and Hearing Impairment Among US Workers 65 Years and Older: National Health Interview Survey, 1997–2004
| Sample, No. | All Older Workers,a No. | Visual Impairment, % (95% CI) | Hearing Impairment, % (95% CI) | Visual and Hearing Impairment, % (95% CI) | Visual or Hearing Impairment, % (95% CI) | |
| All workers | 5 590 | 3 896 639 | 10.2 (9.3, 11.1) | 33.3 (31.9, 34.8) | 5.2 (4.5, 5.9) | 38.4 (36.9, 39.8) |
| White-collar workers | ||||||
| Managers administrators, except public administration | 493 | 354 423 | 9.3 (6.4, 12.2) | 36.4 (31.9, 41.0)b | 6.0 (3.3, 8.7)b | 39.8 (35.3, 44.3) |
| Other administrative support | 484 | 316 321 | 8.2 (5.8, 10.7) | 25.7 (21.2, 30.2) | 2.8 (1.3, 4.3) | 31.1 (26.5, 35.6) |
| Other sales | 434 | 301 408 | 11.2 (7.5, 14.8)b | 31.9 (26.5, 37.4) | 6.1 (3.3, 8.9) | 37.0 (31.4, 42.6) |
| Teachers, librarians, counselors | 251 | 168 762 | 8.2 (4.4, 11.9) | 31.6 (25.0, 38.2) | 2.6 (0.6, 4.6) | 37.1 (30.3, 44.0) |
| Sales representatives, commodities, finance | 243 | 185 712 | 8.2 (4.5, 11.8) | 29.2 (22.8, 35.7) | 4.4 (1.7, 7.1) | 33.1 (26.3, 39.9) |
| Other professional specialty occupations | 199 | 135 104 | 10.9 (6.5, 15.4) | 32.2 (25.4, 39.1) | 5.2 (2.3, 8.1) | 38.0 (30.9, 45.1) |
| Management-related occupations | 193 | 148 715 | 9.1 (4.7, 13.5) | 32.4 (24.4, 40.4) | 3.2 (0.6, 5.8) | 38.3 (30.0, 46.6) |
| Secretaries, stenographers, typists | 162 | 103 852 | 14.2 (8.0, 20.5)b | 24.9 (17.0, 32.8) | 9.2 (3.8, 14.7)b | 29.9 (21.5, 38.3) |
| Supervisors, proprietors | 161 | 118 397 | 9.9 (4.9, 14.9) | 37.6 (29.3, 45.9)b | 5.2 (1.7, 8.7) | 42.3 (33.9, 50.7)b |
| Financial records–processing occupations | 155 | 101 254 | 10.1 (5.3, 14.9) | 22.3 (15.9, 28.7) | 3.4 (0.7, 6.2) | 28.9 (21.6, 36.3) |
| Writers, artists, entertainers, athletes | 131 | 91 404 | 7.3 (3.4, 11.2) | 32.8 (22.0, 43.6) | 2.0 (0.0, 4.0) | 38.1 (27.3, 48.9) |
| Health assessment/treating occupations | 95 | 62 251 | 10.3 (3.1, 17.5) | 23.5 (13.7, 33.3) | 5.5 (0.0, 11.3) | 28.3 (18.0, 38.7) |
| Health-diagnosing occupations | 69 | 60 098 | 9.5 (2.7, 16.3) | 36.6 (26.2, 46.9)b | 7.2 (0.9, 13.5)b | 38.9 (28.2, 49.5) |
| Officials, administrators in public administration | 46 | 31 456 | 5.5 (0.0, 11.9) | 40.3 (24.1, 56.6)b | 3.6 (0.0, 8.9) | 42.2 (25.9, 58.4)b |
| Service workers | ||||||
| Cleaning and building service | 214 | 144 326 | 14.6 (8.7, 20.6)b | 35.6 (28.1, 43.1) | 8.0 (3.6, 12.5)b | 42.2 (34.5, 49.9)b |
| Personal service | 213 | 129 520 | 13.3 (7.8, 18.8)b | 26.0 (19.6, 32.4) | 6.1 (2.6, 9.5)b | 33.2 (26.3, 40.1) |
| Food service | 210 | 124 306 | 10.3 (6.0, 14.7) | 27.3 (20.6, 33.9) | 4.9 (1.7, 8.1) | 32.7 (25.5, 39.9) |
| Health service | 156 | 80 519 | 11.5 (6.0, 17.0) | 25.7 (17.8, 33.5) | 3.7 (0.6, 6.7) | 33.5 (25.1, 42.0) |
| Other protective service occupationsc | 117 | 87 590 | 9.8 (4.1, 15.4) | 37.0 (27.4, 46.6) | 5.0 (1.1, 8.8) | 41.8 (31.9, 51.8) |
| Private household occupations | 106 | 56 265 | 12.6 (4.4, 20.7) | 18.6 (9.7, 27.9) | 4.7 (0.0, 11.4) | 26.5 (16.8, 36.3) |
| Farm workers | ||||||
| Farm operators, managers | 150 | 122 096 | 15.4 (8.9, 21.9)b | 53.9 (46.2, 61.7)b | 12.1 (6.5, 17.7)b | 57.3 (49.3, 65.2)b |
| Farm workers, other agricultural workers | 115 | 72 262 | 11.4 (4.7, 18.1)b | 36.6 (26.8, 46.3)b | 5.3 (0.5, 10.0) | 42.8 (33.2, 52.3)b |
| Blue-collar workers | ||||||
| Motor vehicle operators | 280 | 218 449 | 8.7 (4.8, 12.6) | 42.7 (36.4, 48.9)b | 5.7 (2.7, 8.6) | 45.7 (39.3, 52.1)b |
| Freight, stock, material handlers | 144 | 104 801 | 10.8 (5.7, 15.8) | 37.5 (28.4, 46.6)b | 6.4 (1.8, 11.1)b | 41.9 (33.0, 50.8)b |
| Construction and extractive trades | 119 | 92 573 | 8.6 (2.7, 14.4) | 38.4 (28.8, 48.0)b | 3.4 (0.0, 7.2) | 43.6 (33.6, 53.6) |
| Mechanics, repairers | 114 | 85 786 | 12.7 (6.0, 19.4)b | 46.6 (36.6, 56.6)b | 6.2 (1.5, 10.8)b | 53.1 (43.0, 63.2)b |
| Machine operators/tenderers, except precision | 100 | 70 449 | 8.4 (2.0, 14.8) | 36.2 (26.7, 45.8)b | 6.9 (0.6, 13.2)b | 37.8 (28.1, 47.4) |
| Precision production occupations | 86 | 70 897 | 10.5 (3.4, 17.6) | 32.3 (19.9, 44.7) | 3.7 (0.0, 8.1) | 39.1 (26.5, 51.7) |
| Fabricators, assemblers, inspectors, samplers | 59 | 39 759 | 7.5 (1.3, 13.6) | 43.1 (27.5, 58.6)b | 3.6 (0.0, 7.9) | 46.9 (31.5, 62.4)b |
| NORA industrial sector | ||||||
| Services | 2 295 | 1 603 478 | 9.1 (7.9, 10.6) | 31.4 (29.1, 33.7) | 4.0 (3.2, 5.1) | 33.8 (31.5, 36.2) |
| Wholesale and retail trade | 1 128 | 786 374 | 10.8 (8.9, 13.1) | 32.9 (29.8, 36.1) | 5.5 (4.1, 7.4) | 34.5 (31.3, 37.8) |
| Health care and social assistance | 959 | 602 603 | 11.4 (9.3, 13.9)b | 29.9 (26.9, 33.2) | 5.9 (4.4, 8.0) | 31.3 (27.9, 34.9) |
| Manufacturing | 385 | 282 083 | 9.8 (6.9, 13.7) | 39.7 (34.6, 45.1)b | 6.1 (3.7, 9.8)b | 39.8 (34.3, 45.5) |
| Agriculture, forestry/fishing | 286 | 214 747 | 14.0 (9.9, 19.4)b | 45.0 (39.1, 50.9)b | 9.8 (6.5, 14.4)b | 43.7 (37.7, 49.8)b |
| Construction | 244 | 194 303 | 12.8 (7.9, 20.1)b | 36.4 (29.7, 43.8)b | 5.4 (2.6, 11.2) | 40.6 (33.6, 48.0)b |
| Transportation, warehousing, utilities | 243 | 179.853 | 6.8 (4.0, 11.3) | 36.2 (29.0, 44.1)b | 4.0 (1.9, 8.5) | 36.4 (29.1, 44.4) |
| Mining | 18 | … | … | … | … | … |
Note. CI = confidence interval; NORA = National Occupational Research Agenda. Ellipses indicate groups for which estimates were not stable because of small sample sizes.
Population estimates for the total US older workforce were based on the National Health Interview Survey sampling weights.
Prevalence was outside the 95% confidence bounds for all older workers and was considered to be statistically significantly higher than the impairment prevalence for all older workers at P = .05.17
Protective service occupations other than policemen and firefighters.
Prevalence of visual or hearing impairment or both was higher in older age groups (Table 3). Other subgroups with high prevalence of visual impairment included Hispanic service workers (23.3%), blue-collar workers with incomes at or below the poverty line (21.0%), and workers with less than 12 years of education (14.3%). Across all worker groups, reports of hearing impairment were almost twice as prevalent among men as among women. Other subgroups with high hearing impairment rates included White blue-collar workers (43.5%), non-Hispanic farm workers (50.4%), and farm workers who were married or living with a partner (50.7%).
TABLE 3.
Prevalence of Visual and Hearing Impairment Among US Workers 65 Years and Older, by Occupational Groups and Demographic Characteristics: National Health Interview Survey, 1997–2004
| Sample, No. | All Older Workers,a No. | Visual Impairment, % (95% CI) | Hearing Impairment, % (95% CI) | Visual and Hearing Impairment, % (95% CI) | Visual or Hearing Impairment, % (95% CI) | |
| All workers | ||||||
| Total | 5 590 | 3 896 639 | 10.2 (9.3, 11.1) | 33.3 (31.9, 34.8) | 5.2 (4.5, 5.9) | 38.4 (36.9, 39.8) |
| Gender | ||||||
| Men | 2 763 | 2 180 123 | 10.1 (8.9, 11.4) | 41.8 (39.5, 43.5)b | 5.9 (4.9, 7.0) | 42.2 (40.1, 44.3)b |
| Women | 2 827 | 1 716 516 | 10.4 (9.1, 11.6) | 23.0 (21.2, 24.9) | 4.2 (3.4, 5.0) | 26.2 (24.1, 28.0) |
| Age, y | ||||||
| 65–69 | 2 971 | 2 122 772 | 8.5 (7.4, 9.6) | 28.6 (26.7, 30.5) | 3.8 (3.0, 4.6) | 30.7 (28.7, 32.7) |
| 70–75 | 1 718 | 1 180 597 | 10.9 (9.3, 12.5) | 35.9 (33.3, 38.5)b | 5.3 (4.1, 6.5) | 38.2 (35.5, 40.9) |
| 76–80 | 655 | 436 426 | 13.3 (10.3, 16.3)b | 42.2 (38.1, 46.3)b | 8.7 (6.3, 11.1)b | 41.7 (37.3, 46.1)b |
| ≥ 81 | 246 | 156 844 | 20.1 (14.8, 25.5)b | 53.7 (46.8, 60.6)b | 13.3 (8.6, 18.0)b | 54.4 (47.0, 61.9)b |
| Race | ||||||
| White | 4 833 | 3 475 224 | 9.9 (9.0, 10.9) | 35.2 (33.7, 36.7)b | 5.4 (4.6, 6.1) | 36.3 (34.7, 37.9) |
| Black | 604 | 314 725 | 11.5 (8.8, 14.2) | 14.4 (11.4, 17.5) | 3.1 (1.4, 4.8) | 20.4 (16.7, 24.0) |
| Other | 153 | 106 691 | 16.6 (9.1, 24.0) | 29.4 (19.6, 39.3) | 5.4 (1.2, 9.5) | 37.2 (27.9, 46.7) |
| Ethnicity | ||||||
| Hispanic | 443 | 207 465 | 12.9 (8.1, 17.7)b | 21.3 (16.5, 26.0) | 3.6 (1.8, 5.3) | 28.1 (22.5, 33.6) |
| Non-Hispanic | 5 147 | 3 689 174 | 10.1 (9.2, 11.0) | 34.0 (32.6, 35.5) | 5.6 (4.6, 6.0) | 35.4 (33.9, 36.9) |
| Marital status | ||||||
| Married/living with partner | 2 733 | 2 511 369 | 9.7 (8.5, 10.9) | 36.6 (34.7, 38.5)b | 5.4 (4.5, 6.3) | 37.4 (35.4, 39.4) |
| Divorced/widowed/separated | 2 557 | 1 243 587 | 11.3 (9.9, 12.8) | 27.8 (25.8, 29.7) | 4.7 (3.8, 5.6) | 31.1 (29.0, 33.3) |
| Single | 285 | 134 891 | 10.8 (6.9, 14.6) | 25.3 (19.5, 31.2) | 5.6 (2.6, 8.6) | 26.4 (20.4, 32.5) |
| Economic statusc | ||||||
| At or below the poverty line | 181 | 101 431 | 12.8 (5.1, 20.5) | 28.4 (20.7, 36.1) | 2.4 (0.3, 4.5) | 37.3 (28.6, 46.1) |
| Above the poverty line | 3 710 | 2 559 410 | 10.6 (9.5, 11.7) | 34.7 (33.0, 36.4) | 5.4 (4.6, 6.3) | 36.4 (34.6, 38.2) |
| Education, y | ||||||
| < 12 | 1 144 | 718 539 | 14.3 (11.8, 16.8)b | 33.5 (30.7, 36.3) | 6.5 (4.8, 8.2)b | 37.3 (34.1, 40.5) |
| 12 | 1 803 | 1 284 824 | 9.9 (8.4, 11.5) | 32.8 (30.3, 35.3) | 5.1 (4.0, 6.3) | 34.2 (31.7, 36.7) |
| > 12 | 2 597 | 1 855 086 | 9.1 (7.9, 10.2) | 33.8 (31.7, 35.8) | 4.8 (3.8, 5.8) | 34.9 (32.7, 37.0) |
| Health insurance coverage | ||||||
| No | 5 506 | 3 840 517 | 10.1 (9.2, 11.0) | 33.6 (32.2, 35.1) | 5.2 (4.5, 5.9) | 35.19 (33.7, 36.7) |
| Yes | 78 | 52 298 | 20.3 (5.3, 35.3)b | 14.0 (5.0, 23.1) | 6.3 (0.0, 14.0)b | 23.16 (8.1, 38.2) |
| White-collar workers | ||||||
| Total | 3 324 | 2 329 510 | 9.3 (8.3, 10.4) | 31.1 (29.3, 32.9) | 4.7 (3.8, 5.5) | 32.6 (30.8, 34.5) |
| Gender | ||||||
| Men | 1 444 | 1 159 553 | 8.8 (7.3, 10.3) | 39.4 (36.6, 42.2) | 5.3 (3.9, 6.6) | 39.8 (36.9, 42.7) |
| Women | 1 880 | 1 169 957 | 9.9 (8.5, 11.3) | 22.8 (20.6, 25.1) | 4.1 (3.1, 5.1) | 25.6 (23.3, 28.0) |
| Age, y | ||||||
| 65–69 | 1 769 | 1 277 528 | 7.5 (6.1, 8.9) | 25.5 (23.1, 27.8) | 3.3 (2.3, 4.3) | 27.3 (24.8, 29.8) |
| 70–75 | 1 003 | 688 879 | 9.2 (7.3, 11.1) | 34.8 (31.3, 38.2) | 4.8 (3.3, 6.3) | 36.1 (32.7, 39.5) |
| 76–80 | 396 | 266 739 | 14.2 (10.3, 18.2)b | 41.4 (36.0, 46.8)b | 8.4 (5.3, 11.5)b | 42.4 (36.6, 48.2)b |
| ≥ 81 | 156 | 96 365 | 21.3 (14.4, 28.1)b | 50.7 (42.1, 59.4)b | 11.5 (5.8, 17.1)b | 55.5 (45.8, 65.1)b |
| Race | ||||||
| White | 3 020 | 2 163 316 | 9.2 (8.1, 10.3) | 32.2 (30.3, 34.1) | 4.8 (3.9, 5.7) | 33.5 (31.5, 35.5) |
| Black | 218 | 103 856 | 12.0 (7.6, 16.4)b | 11.9 (7.9, 15.8) | 4.3 (1.5, 7.2) | 15.9 (9.9, 21.8) |
| Other | 86 | 62 338 | 8.6 (2.9, 14.3) | 23.5 (13.1, 33.8) | 0.8 (0.0, 2.0) | 30.7 (18.7, 42.6) |
| Ethnicity | ||||||
| Hispanic | 183 | 85 465 | 6.6 (2.7, 10.5) | 20.6 (13.0, 28.1) | 1.5 (0.1, 2.9) | 24.5 (16.8, 32.3) |
| Non-Hispanic | 3 141 | 2 244 044 | 9.5 (8.4, 10.5) | 31.5 (29.6, 33.4) | 4.8 (3.9, 5.6) | 33.0 (31.0, 34.9) |
| Marital status | ||||||
| Married/living with partner | 1 603 | 1 488 992 | 8.4 (7.0, 9.9) | 33.4 (31.0, 35.9) | 4.6 (3.5, 5.7) | 34.2 (31.6, 36.8) |
| Divorced/widowed/separated | 1 541 | 757 339 | 10.9 (9.2, 12.6) | 27.0 (24.6, 29.4) | 4.7 (3.5, 5.8) | 30.0 (27.3, 32.7) |
| Single | 172 | 79 597 | 11.4 (6.0, 16.8) | 26.3 (19.0, 33.7) | 5.6 (1.5, 9.7) | 28.1 (20.9, 35.3) |
| Economic statusc | ||||||
| At or below the poverty line | 60 | 36 346 | 5.6 (0.5, 10.8) | 28.8 (15.7, 42.0) | 3.6 (0.0, 8.0) | 28.3 (14.8, 41.7) |
| Above the poverty line | 2 270 | 1 562 744 | 9.7 (8.4, 11.1) | 31.8 (29.7, 34.0) | 4.6 (3.6, 5.6) | 33.9 (31.6, 36.2) |
| Education, y | ||||||
| < 12 | 295 | 183 779 | 14.1 (9.6, 18.7)b | 33.4 (27.3, 39.5) | 6.4 (3.1, 9.7)b | 37.0 (31.0, 43.0) |
| 12 | 949 | 665 994 | 9.9 (7.7, 12.0) | 28.0 (24.5, 31.4) | 4.9 (3.3, 6.6) | 29.4 (25.8, 33.0) |
| > 12 | 2 058 | 1 464 211 | 8.6 (7.3, 9.8) | 32.3 (30.0, 34.6) | 4.3 (3.3, 5.3) | 33.7 (31.3, 36.1) |
| Service workers | ||||||
| Total | 1 033 | 635 418 | 12.2 (9.8, 14.6)b | 29.3 (25.9, 32.6) | 5.8 (4.1, 7.6) | 31.7 (28.3, 34.9) |
| Gender | ||||||
| Men | 326 | 241 229 | 13.5 (9.2, 17.7)b | 39.9 (33.9, 45.9) | 8.1 (4.6, 11.5)b | 40.5 (34.4, 46.5)b |
| Women | 707 | 394 189 | 11.5 (8.6, 14.3)b | 22.7 (19.3, 26.2) | 4.5 (2.7, 6.3)b | 26.5 (22.9, 30.0)b |
| Age, y | ||||||
| 65–69 | 519 | 322 762 | 10.4 (7.1, 13.6) | 26.5 (22.1, 30.9) | 4.7 (2.4, 6.9) | 28.9 (24.2, 33.6) |
| 70–75 | 350 | 216 831 | 14.3 (10.2, 18.4)b | 29.1 (23.1, 35.1) | 5.5 (2.9, 8.2) | 34.3 (28.5, 40.0) |
| 76–80 | 121 | 69 856 | 12.4 (5.0, 19.9)b | 36.0 (27.0, 45.1) | 8.9 (2.6, 15.2)b | 33.6 (24.6, 42.6) |
| ≥ 81 | 43 | 25 969 | 17.8 (4.4, 31.2)b | 46.1 (28.2, 64.0)b | 14.8 (1.9, 27.6)b | 40.3 (21.4, 59.3)b |
| Race | ||||||
| White | 746 | 484 412 | 11.3 (8.7, 13.9)b | 31.6 (27.6, 35.6) | 5.7 (3.8, 7.6) | 33.4 (29.5, 37.3) |
| Black | 247 | 127 314 | 11.7 (7.0, 16.4)b | 17.8 (12.5, 23.2) | 3.8 (1.0, 6.6) | 22.9 (16.9, 28.8) |
| Other | 40 | 23 692 | 33.2 (15.1, 51.2)b | 42.3 (25.2, 59.3)b | 19.3 (3.9, 34.6)b | 45.7 (28.9, 62.4)b |
| Ethnicity | ||||||
| Hispanic | 119 | 50 914 | 23.3 (12.2, 34.4)b | 26.3 (17.7, 35.0) | 9.7 (2.5, 16.9) | 33.4 (23.0, 43.9) |
| Non-Hispanic | 914 | 584 504 | 11.3 (8.9, 13.6)b | 29.5 (25.9, 33.1) | 5.5 (3.7, 7.3) | 31.5 (28.0, 35.0) |
| Marital status | ||||||
| Married/living with partner | 353 | 307 325 | 12.3 (8.6, 16.1)b | 34.4 (28.5, 40.2) | 6.9 (4.0, 9.7)b | 35.4 (29.7, 41.2) |
| Divorced/widowed/separated | 613 | 297 266 | 12.4 (9.1, 15.6)b | 25.0 (21.0, 29.0) | 4.8 (2.8, 6.8) | 29.1 (24.9, 33.4) |
| Single | 60 | 27 615 | 11.1 (3.0, 19.2) | 20.1 (9.6, 30.5) | 6.5 (0.3, 12.7)b | 19.5 (8.6, 30.5) |
| Economic statusc | ||||||
| At or below the poverty line | 76 | 34 065 | 16.1 (7.0, 25.3)b | 28.7 (18.1, 39.3) | 3.3 (0.0, 7.4) | 39.5 (28.4, 50.6) |
| Above the poverty line | 623 | 384 814 | 11.9 (9.0, 14.8)b | 33.1 (28.7, 37.5) | 6.2 (4.0, 8.5) | 34.7 (30.4, 39.0) |
| Education, y | ||||||
| < 12 | 397 | 219 309 | 16.7 (12.1, 21.2)b | 27.1 (21.8, 32.3) | 6.4 (3.6, 9.2)b | 33.0 (27.5, 38.5) |
| 12 | 386 | 257 831 | 8.4 (5.3, 11.6) | 28.1 (22.7, 33.5) | 4.2 (1.9, 6.6) | 29.3 (23.7, 34.9) |
| > 12 | 238 | 147 154 | 13.2 (8.1, 18.2)b | 35.5 (28.7, 42.4) | 8.2 (4.0, 12.5) | 35.1 (27.9, 42.3) |
| Farm workers | ||||||
| Total | 275 | 204 035 | 13.6 (8.9, 18.2)b | 47.9 (41.6, 54.1)b | 9.1 (5.3, 12.8)b | 47.6 (41.0, 54.2)b |
| Gender | ||||||
| Men | 227 | 169 720 | 14.7 (9.4, 20.0)b | 52.0 (45.0, 58.9)b | 9.6 (5.3, 13.8)b | 52.5 (45.2, 59.8)b |
| Women | 48 | 34 315 | 8.2 (0.0, 16.4) | 27.5 (12.9, 42.2) | 6.7 (0.0, 14.3)b | 24.0 (9.5, 38.5) |
| Age, y | ||||||
| 65–69 | 130 | 95 190 | 11.2 (5.3, 17.1)b | 41.0 (31.9, 50.0)b | 4.5 (0.5, 8.5) | 45.2 (35.6, 54.8)b |
| 70–75 | 76 | 58 133 | 12.5 (3.4, 21.5)b | 47.0 (35.3, 58.7)b | 9.9 (1.7, 18.1)b | 44.0 (31.2, 56.7)b |
| 76–80 | 49 | 35 921 | 15.2 (4.8, 25.5)b | 55.4 (40.3, 70.5)b | 12.5 (3.0, 21.9)b | 52.2 (36.3, 68.0)b |
| ≥ 81 | 20 | … | … | … | … | … |
| Race | ||||||
| White | 249 | 189 897 | 13.0 (8.3, 17.7)b | 50.1 (43.8, 56.5)b | 9.8 (5.7, 13.8)b | 48.4 (41.3, 55.4)b |
| Black | 21 | … | … | … | … | … |
| Other | 5 | … | … | … | … | … |
| Ethnicity | ||||||
| Hispanic | 27 | 12 488 | 0.0 (0.0, 0.0) | 8.8 (0, 21.5) | 0.0 (0.0, 0.0) | 8.8 (0.0, 21.5) |
| Non-Hispanic | 248 | 191 546 | 14.5 (9.5, 19.4)b | 50.4 (44.1, 56.7)b | 9.7 (5.7, 13.7)b | 50.4 (43.7, 57.1)b |
| Marital status | ||||||
| Married/living with partner | 186 | 161 853 | 13.1 (7.6, 18.5)b | 50.7 (43.5, 57.9)b | 8.7 (4.4, 13.1)b | 50.8 (43.1, 58.5)b |
| Divorced/widowed/separated | 69 | 31 531 | 16.8 (6.7, 26.9)b | 36.6 (24.6, 48.6) | 10.0 (1.3, 18.7)b | 37.1 (25.4, 48.8) |
| Single | 20 | … | … | … | … | … |
| Economic statusc | ||||||
| At or below the poverty line | 16 | … | … | … | … | … |
| Above the poverty line | 154 | 115 223 | 15.9 (9.3, 22.4)b | 48.6 (41.1, 56.1)b | 10.9 (5.4, 16.4)b | 47.8 (39.5, 56.1)b |
| Education, y | ||||||
| < 12 | 106 | 74 796 | 8.9 (3.0, 14.7) | 47.1 (35.5, 58.6) | 4.8 (0.3, 9.3) | 48.7 (37.0, 60.4) |
| 12 | 110 | 83 806 | 17.8 (9.8, 25.7)b | 49.6 (40.4, 58.7)b | 11.0 (4.6, 17.4)b | 50.9 (41.4, 60.4)b |
| > 12 | 56 | 43 441 | 14.4 (4.7, 24.0)b | 45.9 (31.4, 60.4)b | 13.2 (3.8, 22.6)b | 39.1 (22.8, 55.3) |
| Blue-collar workers | ||||||
| Total | 958 | 727 677 | 10.4 (8.1, 12.6) | 40.1 (36.8, 43.4)b | 5.3 (3.7, 6.8) | 42.2 (38.5, 45.8)b |
| Gender | ||||||
| Men | 766 | 609 621 | 10.1 (7.6, 12.7) | 43.1 (39.4, 46.7)b | 5.5 (3.7, 7.3) | 44.7 (40.7, 48.7)b |
| Women | 192 | 118 056 | 11.7 (7.0, 16.4)b | 24.8 (17.8, 31.7) | 4.1 (1.2, 7.1) | 29.4 (21.9, 36.9) |
| Age, y | ||||||
| 65–69 | 553 | 427 292 | 9.5 (6.8, 12.3) | 36.9 (32.4, 41.4) | 4.6 (2.8, 6.5) | 39.0 (34.1, 43.9) |
| 70–75 | 289 | 216 755 | 12.4 (8.1, 16.7)b | 43.1 (36.7, 49.6)b | 5.3 (2.4, 8.3) | 47.3 (40.7, 54.0)b |
| 76–80 | 89 | 63 910 | 9.2 (2.7, 15.7) | 44.8 (33.1, 56.5) | 7.6 (1.5, 13.8)b | 42.0 (29.8, 54.1)b |
| ≥ 81 | 27 | 19 720 | 10.4 (0.0, 23.9) | 60.8 (41.0, 80.6) | 10.4 (0.0, 23.9)b | 56.3 (35.0, 77.7)b |
| Race | ||||||
| White | 818 | 637 599 | 10.2 (7.9, 12.6) | 43.5 (39.9, 47.0)b | 5.8 (4.1, 7.5) | 44.6 (40.8, 48.5)b |
| Black | 118 | 71 673 | 8.1 (2.5, 13.6) | 11.9 (6.2, 17.5) | 0.6 (0.0, 1.8) | 18.8 (10.4, 27.3) |
| Other | 22 | … | … | … | … | … |
| Ethnicity | ||||||
| Hispanic | 114 | 58 598 | 15.9 (2.7, 29.0)b | 20.6 (11.8, 29.4) | 2.0 (0.0, 4.7) | 33.2 (20.4, 46.0) |
| Non-Hispanic | 844 | 669 079 | 9.9 (7.7, 12.1) | 41.8 (38.4, 45.2)b | 5.5 (3.9, 7.2) | 43.0 (39.2, 46.8)b |
| Marital status | ||||||
| Married/living with partner | 591 | 553 199 | 10.5 (7.7, 13.4) | 42.1 (38.2, 46.1)b | 5.8 (3.9, 7.8) | 43.6 (39.1, 48.0)b |
| Divorced/widowed/separated | 334 | 157 451 | 10.3 (6.8, 13.7) | 35.0 (29.1, 40.8) | 3.8 (1.7, 5.8) | 39.1 (33.2, 45.0) |
| Single | 33 | 17 027 | 6.5 (0.0, 14.1) | 21.3 (5.9, 36.8) | 0.0 (0.0, 0.0)b | 27.8 (11.5, 44.1) |
| Economic statusc | ||||||
| At or below the poverty line | 29 | 22 921 | 21.0 (0.0, 48.4)b | 25.7 (8.4, 43.0) | 0.0 (0.0, 0.0)b | 46.7 (22.5, 70.8)b |
| Above the poverty line | 663 | 496 629 | 11.1 (8.4, 13.9) | 41.7 (37.8, 45.7)b | 6.1 (4.1, 8.1)b | 43.3 (39.0, 47.6)b |
| Education, y | ||||||
| < 12 | 346 | 240 655 | 14.0 (9.1, 19.0)b | 35.3 (29.9, 40.6) | 7.1 (3.9, 10.2)b | 37.8 (31.5, 44.1) |
| 12 | 358 | 277 193 | 9.0 (5.9, 12.1) | 43.8 (38.2, 49.3)b | 4.7 (2.4, 7.1) | 45.4 (39.6, 51.3)b |
| > 12 | 245 | 200 280 | 8.4 (4.4, 12.4) | 40.4 (33.7, 47.1)b | 4.0 (1.3, 6.7) | 42.5 (35.2, 49.7)b |
Note. CI = confidence interval. Ellipses indicate groups for which estimates were not stable because of small sample sizes.
Population estimates for the total US older workforce were based on the National Health Interview Survey sampling weights.
Prevalence was outside the 95% confidence bounds for all older workers and was considered to be statistically significantly higher than the impairment prevalence for all older workers at P = .05.17
Approximately 35% of older workers did not report financial data; therefore, caution should be taken when interpreting these findings.
DISCUSSION
To our knowledge, this is the only study to date that evaluated recent national data on sensory impairment among older workers. We found that a high prevalence of hearing and visual impairment was present among older workers. Visual impairment was especially common among those with lower educational attainment, for all groups except farm workers. Respondents employed in the agriculture, forestry–fishing, and construction sectors had the highest prevalence of sensory impairment.
There are 2 possible explanations for these findings. First, hearing impairment could be caused by harmful occupational exposures such as high noise levels, which are well documented among farmers, construction workers, and machine operators.6,18–21 Visual impairment could be caused by occupation-related increases in ocular disease risk factors (e.g., sun exposure) and eye injuries (e.g., exposure to chemicals, dust, radiation, welding, agricultural products, penetration of foreign bodies),22,23 which appear to be relatively common among workers in the custodial, home repair, health care, agriculture, and manufacturing industries.23–26 Second, some occupations may be more accommodating to sensory-impaired individuals and therefore more likely to employ them27; this may explain the high prevalence of visual impairment among employees in administrative occupations (e.g., secretaries, stenographers, typists).
Our study was limited by (1) its cross-sectional design; (2) its reliance on self-reported measures, which were modestly correlated with clinical measures of hearing and visual impairment28,29; and (3) its inability to control for gender and household income (because of model overspecification), which we found to be correlated with occupation and sensory impairment and could therefore explain our findings.
Ideally, all employers would provide appropriate workplace accommodations for sensory-impaired employees, thus promoting equal employment opportunities. However, studies suggest that the provision of workplace accommodations has been inadequate in some occupations (e.g., mechanics and construction), particularly for workers who are hearing impaired.30 Noncompliance with Americans with Disabilities Act accommodation policies could stem from employer concerns about high implementation costs and worker productivity.31 Better communication is clearly needed about the feasibility, implementation, and costs of legally mandated accommodations for disabled employees.
The law notes that disability does not necessarily translate to an inability to work, as long as proper workplace accommodations are provided. Our findings that nearly 40% of older workers have sensory impairment highlight the growing need for such workplace accommodations, particularly given the expected increase in older workers in the coming years.1 Particular attention should be directed to occupations and industries with a high prevalence of impaired workers, because they are at the greatest risk for workplace injuries and most in need of assistive devices.4,5 Although not mandated by the Americans with Disabilities Act,32 providing access to low-cost hearing aids and prescription glasses might improve safety and increase productivity. Sensory aids also appear to improve quality of life among the sensory impaired.33 Finally, our findings suggest a need for preventive measures among potentially vulnerable worker groups with sensory impairment. Research is needed to determine whether sensory aids and other workplace accommodations enhance worker productivity and job satisfaction as well as reduce injury risk.
Acknowledgments
This study was supported by the National Eye Institute (grant R03-EY016481) and the National Institute on Occupational Safety and Health (grant R01-0H03915).
Human Participant Protection
This study was approved by the University of Miami's Miller School of Medicine institutional review board.
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